Abstract
BackgroundNeuroendocrine tumors, although relatively rare in incidence, are now the second most prevalent gastrointestinal neoplasm owing to indolent disease biology. A small but significant sub-group of neuroendocrine tumor patients suffer from diarrhea. This is usually secondary to carcinoid syndrome but can also be a result of short gut syndrome, bile acid excess or iatrogenic etiologies. Recently, an amino acid based oral rehydration solution (enterade® Advanced Oncology Formula) was found to have anti-diarrheal properties in preclinical models.MethodsA retrospective chart review of all NET patients treated with enterade® AO was performed after IRB approval.ResultsNinety-eight NET patients who had received enterade® AO at our clinic from May 2017 through June 2019 were included. Patients (N = 49 of 98) with follow up data on bowel movements (BMs) were included for final analysis. Eighty-four percent of patients (41/49) had fewer BMs after taking enterade® AO and 66% (27/41) reported more than 50% reduction in BM frequency. The mean number of daily BMs was 6.6 (range, 3–20) at baseline before initiation of therapy, while the mean number of BMs at 1 week time point post enterade® AO was 2.9 (range, 0–11).ConclusionsOur retrospective observations are encouraging and support prospective validation with appropriate controls in NET patients. This is first published report of the potential anti-diarrheal activity of enterade® AO in NET patients.
Highlights
Neuroendocrine tumors, relatively rare in incidence, are the second most prevalent gastrointestinal neoplasm owing to indolent disease biology
Diarrhea and bowel movements (BM) frequency in functional Neuroendocrine tumor (NET) patients is typically managed with somatostatin analogs and telotristat ethyl
We examined the potential for enterade® Advanced Oncology (AO) Formula to reduce BM frequency in NET patients
Summary
Patient characteristics We identified 98 NET patients who had received enterade® AO at our clinic from May 2017 through June 2019. Patients (N = 49 of 98) with follow up data on BMs were included for final analysis. Twenty-eight patients (57%) had a history of prior bowel resection either for primary NET resection or debulking. Twenty-eight patients (57%) were on somatostatin analogs at the time of initiation of enterade® AO. Antidiarrheal efficacy of enterade® AO Eighty-four percent of patients (41/49) had fewer BMs after taking enterade® AO and 66% (27/41) reported more than 50% reduction in BM frequency. The mean number of daily BMs was 6.6 (range, 3–20) at baseline before initiation of therapy, while the mean number of BMs at day 7 after starting enterade® AO was 2.9 (range, 0–11).
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